Patient-mounted micro vein enhancer

ABSTRACT

The present invention is a Miniature Vein Enhancer, for use in imaging the subcutaneous veins of a target area of a patient by a practitioner. The miniature vein enhancer includes a Miniature Projection Head that is secured to a tourniquet, where the tourniquet may be mounted to the bicep of a patient. The Miniature Projection Head includes a housing, and apparatus that images subcutaneous veins of the target area, and projects the image(s) of the veins onto the target area to overlie the subcutaneous veins, which aids the practitioner in pinpointing a vein location for a venipuncture procedure such as an intravenous drip, blood test, and the like.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.15/683,853, filed on Aug. 23, 2017, which is a continuation of U.S.application Ser. No. 14/705,000, filed on May 6, 2015, now issued asU.S. Pat. No. 9,788,787, which is a continuation of U.S. applicationSer. No. 13/648,390, filed Oct. 10, 2012, now issued as U.S. Pat. No.9,044,207, which is a continuation of U.S. application Ser. No.13/287,223, filed Nov. 2, 2011, now issued as U.S. Pat. No. 8,295,904,which is a continuation of U.S. application Ser. No. 11/605,069, filedNov. 28, 2006, now issued as U.S. Pat. No. 8,073,531, which is adivision of U.S. application Ser. No. 11/478,322, filed Jun. 29, 2006,now issued as U.S. Pat. No. 8,478,386, which claims priority from U.S.Provisional Application Ser. No. 60/757,704, entitled “Micro VeinEnhancer,” filed on Jan. 1, 2006, all disclosures of which are herebyincorporated by reference.

FIELD OF INVENTION

A miniature laser based vein contrast enhancer that can fit intoportable hand held products that a practitioner can carry in theirpocket.

BACKGROUND OF THE INVENTION

It is known in the art to use an apparatus to enhance the visualappearance of the veins in a patient to facilitate insertion of needlesinto the veins. An example of such a system is described in U.S. Pat.Nos. 5,969,754 and 6,556,858 incorporated herein by reference as well asa publication entitled “The Clinical Evaluation of Vein ContrastEnhancement”. Luminetx is currently marketing such a device under thename “Veinviewer Imaging System” and information-related thereto isavailable on its website, which is incorporated herein by reference.

The Luminetx Vein Contrast Enhancer (hereinafter referred to as LVCE)utilizes an infrared light source for flooding the region to be enhancedwith infrared light generated by an array of LEDs. A CCD imager is thenused to capture an image of the infrared light reflected off thepatient. The resulting captured image is then projected by a visiblelight projector onto the patient in a position closely aligned with theimage capture system. Given that the CCD imager and the image projectorare both two dimensional, and do not occupy the same point in space, itis relatively difficult to design and build a system that closely alignsthe captured image and the projected image.

A further characteristic of the LVCE is that both the imaging CCD andthe projector have fixed focal lengths. Accordingly, the patient must beat a relatively fixed distance relative to the LVCE. This necessitatesthat the LVCE be positioned at a fixed distance from the region of thepatient to be enhanced.

The combination of the size of the LVCE and the fixed focal arrangementprecludes using the LVCE as small portable units that are hand held.

SUMMARY OF INVENTION

Finding a vein, necessary for administering intravenous solutions, dripsand the like, can often be difficult. During venous penetration, whetherfor an injection or drip, it is essential to stick a vein in exactly theright location. If a practitioner is only slightly off center, theneedle will more then likely just roll off.

The present invention is a Miniature Vein Enhancer that includes aMiniature Projection Head and a mounting means for the MiniatureProjection head. The Miniature Projection Head of the present inventionimplements a polarized laser light. This diminishes the effects ofspecular reflection off the surface of the skin. The Veinviewer ImagingSystem, produced by Luminetx, uses a polarized filter to polarize theLED light. This polarized LED light is then rotated 90° in front of thecamera, thus causing increased power loss. In addition, the IR andvisible lasers in the present invention are modulated to allow a regularphotodiode to detect the different signals from each wavelengthseparately. Furthermore, the IR laser power of the present invention isdynamically altered during each scan line, thus increasing the workingrange of the photodiode, and allowing for constant DC gain.

The miniature vein enhancer of the present invention may be used by apractitioner to locate a vein, particularly useful when trying to locatea vein in the very old or very young. More then fifty percent ofattempts to find a vein in old people, who have a generally highpercentage of loose, fatty tissue, and children, who have a generallyhigh percentage of small veins and “puppy fat” are unsuccessful. Thepresent invention is aimed at reducing and/or preventing the discomfortand delay associated with botched attempts to pierce veins forinjections and blood tests. In addition, the present invention can cutthe time it takes to set up potentially life-saving intravenous drip.

OBJECTS OF THE INVENTION

It is an object of the present invention to make a Miniature VeinEnhancer that is cost effective to manufacture.

It is another object of the present invention to make a Miniature VeinEnhancer that will allow a practitioner pinpoint a vein for intravenousdrip, blood tests, and the like.

It is still another object of the present invention to make a MiniatureVein Enhancer that will reduce and/or diminish the amount of botchedattempts to pierce a vein.

It is still a further object of the present invention to make aMiniature Vein Enhancer that is easy to operate.

It is another object of the present invention to make a Miniature VeinEnhancer that may be disposed of after use.

It is yet another object of the present invention to make a MiniatureVein Enhancer that may be hand held.

It is still another object of the invention to make a Miniature VeinEnhancer that implements a Miniature Projection Head in Alternatingframe mode.

It is yet another object of the present invention to make a MiniatureVein Enhancer that implements a Miniature Projection Head that operatesin Dual Buffer Mode.

It is yet another object of the present invention to make a MiniatureVein Enhancer that implements a Miniature Projection Head that operatesin Real Time Mode.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a representation showing the use of the miniature veinenhancer of the present invention on a patient.

FIG. 2A shows a side view of the top cavity section removed from thebody of the miniature vein enhancer of FIG. 1.

FIG. 2B shows a side view of the body of the miniature vein enhancer ofFIG. 1.

FIG. 2C shows a side view of the body with the top cavity sectionremoved.

FIG. 2D shows a side view of the body with the left and right wallpivoting about their respective pivot points.

FIG. 2E is a rear view of the body with the top cavity section in place.

FIG. 2F is a side view of the body of FIG. 2E.

FIGS. 3A to 3F show an alternative embodiment of the miniature veinenhancer of the present invention where the top cavity section isfixedly attached to the body.

FIGS. 4A and 4B show an alternative vial holder used with the presentinvention.

FIGS. 5A to 5C show an alternative mounting embodiment for an MVE.

FIGS. 6A and 6B show an alternative embodiment of the MVE of the presentinvention.

FIG. 7 shows a still further embodiment of the MVE of the presentinvention that is particularly useful for accessing veins in the arms ofpatients.

FIG. 8 shows an embodiment of the invention where the MVE is mounted ona base.

FIG. 9 shows an MVE on a base with a flexible “gooseneck” arm.

FIG. 10 shows an MVE with an alternative type of gooseneck.

FIGS. 11A to 11D show the MVE of the present invention removably mountedto a phlebotomist's chair.

FIGS. 12A-12B shows a prior art vial holder.

FIG. 13A shows an improved vial holder that has particular applicationto the present invention.

FIG. 13B is a side view of the MPH mounted to the improved vial holderdepicted in FIG. 13A.

FIG. 13C is a top view of the MPH mounted to the improved vial holderdepicted in FIG. 13A in a scale of 1:1.

FIG. 13D is a side view of the MPH mounted to the improved vial holderdepicted in FIG. 13A in a scale of 1:1.

FIG. 13E is a front view of the MPH mounted to the improved vial holderdepicted in FIG. 13A in a scale of 1:1.

FIGS. 14A to 14B depict an embodiment of the present invention in whichthe MVE is integrated into a magnifying glass housing.

FIG. 14C is a rear view of another embodiment of the present inventionwith a display used to view the image of the miniature vein enhancer.

FIG. 14D is a front view of the embodiment depicted in FIG. 14C.

FIG. 14E is a front view of the embodiment depicted in FIG. 14C with theminiature projection head located on the lower portion of the display.

FIGS. 15a to 15d depict an embodiment of the present invention in whichMVE has a disposable stand.

FIGS. 16a to 16c depict an embodiment of the present invention in whichthe MVE implements a different disposable type of stand.

FIG. 17a is a perspective view of the MVE attached to a disposablemounting bracket.

FIG. 17b is a perspective view of the ring portion of the mountingbracket of the MVE depicted in FIG. 17 a.

FIG. 17c is an exploded view of the MVE depicted in FIG. 17 a.

FIG. 17d is a side view of the MVE depicted in FIG. 17a with apractitioner asserting a downward force.

FIG. 18a is a perspective view of the MVE attached to a disposablemounting bracket having a support ring.

FIG. 18b is a perspective view of the ring portion of the mountingbracket of the MVE depicted in FIG. 18 a.

FIG. 18c is an exploded view of the MVE depicted in FIG. 18 a.

FIG. 18d is a side view of the MVE depicted in FIG. 18a with apractitioner asserting a downward force.

FIG. 19a is a perspective view of the MVE attached to a disposablemounting bracket having a support ring that implements a support post.

FIG. 19b is a perspective view of the ring portion of the mountingbracket of the MVE depicted in FIG. 19 a.

FIG. 19c is a side view of the MVE depicted in FIG. 19a with apractitioner asserting a downward force, after use, so as to cover theneedle.

FIG. 19d is an exploded view of the MVE depicted in FIG. 19 a.

FIG. 20a perspective view of the MVE attached to a disposable syringe.

FIG. 20b is a front view of the MVE depicted in FIG. 20 a.

FIG. 21a is a side view of the MVE with a MPH bracket and disposableshield.

FIG. 21b is a perspective view of the MPH depicted in FIG. 21 a.

FIG. 22a is an exploded view of the MVE with the MPH having a knurledcap for battery access.

FIG. 22b is a side view of the MVE depicted in FIG. 22a in a hand heldversion.

FIG. 22c is a side view of the MVE depicted in FIG. 22a with a screw onbezel.

FIG. 22d is front view of the holder of the MVE depicted in FIG. 22 a.

FIG. 22e is a side view of the MVE depicted in FIG. 22a attached to theneedle cover.

FIG. 23a is a side view of the MVE with a hexagonal body shape.

FIG. 23b is a front view of the holder of the MVE depicted in FIG. 23 a.

FIG. 23c is a side view of the MVE depicted in FIG. 23a attached to theneedle cover.

FIG. 23d is a side view of the MVE depicted in FIG. 23a with a stringattached.

FIG. 24a is a side view of the MVE attached to a flashlight.

FIG. 24b is a perspective view of the MPH of the MVE depicted in FIG.24a attached to a needle cover.

FIG. 24c is a side view of the MVE depicted in FIG. 24a with the MPHdetached from the flashlight.

FIG. 24d is a bottom view of the MVE depicted in FIG. 24a with the MPHdetached from the flashlight.

FIG. 24e is a side view of the MVE depicted in FIG. 24a being held in apractitioners hand.

FIG. 24f is a bottom view of the MVE in a scale of 1:1.

FIG. 24g is a perspective view of the MVE in a scale of 1:1.

FIG. 24h is a side view of the MVE in a scale of 1:1.

FIG. 24i is a front view of the MPH of the MVE in a scale of 1:1.

FIG. 25a is a top view of another embodiment of the MVE of the presentinvention.

FIG. 25b is a side view of the MVE depicted in FIG. 25 a.

FIG. 25c is a side view of the MVE depicted in FIG. 25a attached to avial.

FIG. 25d is a side view of the MVE depicted in FIG. 25a being held inthe hand of a practitioner.

FIG. 25e is a side view of the top portion of the needle cover of theMVE depicted in FIG. 25 a.

FIG. 26a is a perspective view of the MVE with a generally pear shapedbattery holder.

FIG. 26b is a side view of the MVE depicted in FIG. 26a mounted to aneedle cover.

FIG. 26c is an exploded view of the MVE depicted in FIG. 26 a.

FIG. 26d is a perspective view of the MVE depicted in FIG. 26a beingheld in the hand of a practitioner.

FIG. 27a is a perspective view of the MVE with a generally rectangularbattery holder.

FIG. 27b is a side view of the MVE depicted in FIG. 27a mounted to aneedle cover.

FIG. 27c is a side view of the MVE depicted in FIG. 27a with the MPHbeing slidably attached.

FIG. 27d is a side view of the MVE depicted in FIG. 27e 34a being heldin the hand of a practitioner.

FIGS. 28A and 28B represent the image of veins on the patient field ofview.

FIG. 29 depicts a prior art scanning laser based camera.

FIG. 30 illustrates an example of the MPH of the present invention.

FIG. 31 shows a control block diagram for the MPH.

FIG. 32 shows the Dual Buffer Mode of operation of the MPH.

FIG. 33 depicts the Real Time Mode of operation of the MPH.

DETAILED DESCRIPTION OF THE INVENTION

FIG. 1 shows a miniature vein enhancer (MVE) 1 for enhancing a targetarea 4 of a patient's arm 3. The MVE 1 has miniature projection head(MPH) 2 for both imaging the target area 4 and for projecting anenhanced image 11 along optical path. 5 onto the target area 4. The MPHwill be described in detail later with reference to FIG. 18-FIG. 21. TheMPH 2 is housed in a cavity section preferably a top cavity section 12of the MVE 1. The body 13 of the MVE 1 is positioned below the topcavity section 12. The body 13 has a vial opening 8 for receiving andtemporarily holding in place a vial holder 7 having a needle 14. Thebody 13 also has a thumb opening 9 through which the medicalpractitioner 6 can place their thumb 10 while utilizing the MVE 1. Thevial opening 8 is preferably provided with at least a curved basesection 8A for receiving the curved exterior surface of the vial holder7 and retaining it in position. The thumb opening 9 may be a separateorifice or it may be part of the vial opening 8.

The functioning of the MVE 1 of FIG. 1 follows. A medical practitioner 6places a standard vial holder 7 into the vial opening 8. The vialopening 8 is shaped such that it snuggly holds the vial holder 7 inplace. MVE 1 is preferably battery operated and is turned on by thepractitioner 6 via an on/off switch not shown. Alternatively the unitcan be turned on/off by a switch which detects the presence of the vialholder 7 in vial opening 8. The practitioner 6 places his thumb 10though the thumb opening 9 and supports the bottom of the vial holder 7with his forefinger. This mimics the normal grip that many practitionersuse when grasping a vial holder for insertion into the veins of thepatient. As the MVE 1 is brought close to the patients arm 3 the MPH 2takes an image of the of the patient's 3 veins 11 within the target area4. After receiving the image, the MPH projects along the optical path 5onto the target area 4 a visible image of the veins.

The portable size of the MVE provides many advantages over the prior artunits. The prior art units are too large to be held with a single hand,and in fact are fix mounted or mounted on rolling carts. This presentinvention is small enough to be portably carried by mobile workers, suchas, doctors, nurses, emergency health workers, military personnel,police, and visiting home phlebotomists. The portable MVE can be movedquickly over the patient body thereby viewing a large number of veins ina short period of time. Further, the single handed operation of the MVEfrees up the second hand of the care giver for other purposes.

FIG. 2A-2F illustrates in further detail the MVE 1 of FIG. 1. FIG. 2Ashows the top cavity section 12 disconnected from the body 13. At leastone but preferably two holes 15 for removably mounting the top cavitysection 12 to the body 13 are situated on each side of the top cavitysection 12. FIGS. 2B and 2C show the body from two differentperspectives. The body has a protrusion 16 which are shaped to fit intothe holes 15 on the top cavity section 12, thereby facilitatingremovable attachment of the body 13 to the top cavity section 12. Itwill be appreciated by those skilled in the art that the orifices 15could be in the body 13 and the protrusions 16 in the top cavity section12. FIGS. 2C and 2D show the body 13 with the top cavity section 12removed. A cross member 18 connects to the left wall 20 and right wall21 at pivot points 17. When release buttons 19 are squeezed together thebottoms of the left 20 and right walls 21 move apart increasing the sizeof the vial opening 8, thereby releasing a pressure hold on the vialholder 7 (not shown). When the top cavity 12 is inserted back into thebody 8, the top cavity 12 applies an outward force at the tops of theleft wall 20 and right wall 21 thereby reducing the size of the vialopening 8, thereby insuring a snug connection between the vial holder 7and the body 13. Similarly, inward pressure on the left wall 20 andright wall 21 at the bottom thereof applies an outward force at the topsof the left wall 20 and right wall 21 permitting easy insertion of thetop cavity section 12 between the left and right wall on the body.

Further detail of the body 13 is shown in FIG. 2E and FIG. 2F. FIG. 2Eis a rear view of the body 13 and FIG. 2E is a side view of the body 13.The removable top cavity section 12 snaps into place in the body 13 andis held in place by protrusions 16 which insert into the holes 15 (notshown in FIGS. 2E and 2F). The protrusions 16 disengage from the holes15 when the left 20 and right walls 21 are pressed towards each other.

FIG. 3A-3F shows another embodiment of the present invention. FIGS.3A-3F also shows an illustrative sequence of using the MVE. In FIG. 3Athe MVE 1 is similar to that of FIG. 2A-2F except that it has a topcavity section 12 which is fixedly attached to the body 13. The bottomportion of the body 13 has two sides 30 and 31 extending downward withan opening on the bottom for receiving the vial holder 7. The two sides30 and 31 are normally biased so as to form a tight friction fit aroundthe vial holder 7, but the vial holder can be loosened by depressingsimultaneously at points on the body under the thumb and index finger ofthe practitioner's left hand as shown in FIG. 3A to allow easyattachment between the vial holder 7 and the MVE 1.

The first step of operation is shown in FIG. 3A wherein the practitioner6 holds the body 13 of the MVE 1 and squeezes (between the thumb andindex finger) to release the bias of the two sides 30 and 31. Thepractitioner 6 then takes a new vial holder 7, positions it in betweenthe two sides 30 and 31 and releases the pressure between the thumb andindex finger thereby allowing the sides to move towards their normallybiased position around the vial holder 7. The MVE 1 is now removablyattached to the vial holder 7. Alternatively, where the vial holder 7 ismade of a flexible material, the thumb and index finger may squeeze thevial holder 7 to release it from the body.

The second step of operation is shown in FIG. 3B wherein thepractitioner activates the MPH 2 (not shown in these figures) containedwithin the head of the top cavity section 12. FIG. 3B shows thisactivation being performed by depressing a button 32 on the top of theMVE 1, or alternatively, the unit can automatically initiate when theMVE is attached to the vial holder 7.

FIG. 3C shows the practitioner 6 approaching the arm of a patient 3 withthe MVE 1. The optical path 5 and the field of view 4 of the MVE 1 areshown in FIG. 3C. At this time the veins 11 of the patients 3 arm arevisually projected from the MPH 2 onto the patients arm. A significantadvantage of the MPH 2 used in a handheld configuration is the fact thatthe image at the field of view 4 is always in focus, regardless of thedistance from the MPH 2 to the patient 3. Since the distance between theMPH 2 and the patient is constantly decreasing as the MVE 1 approachesthe patient 3, the prior art systems, which have limited fields of view,would not work property in such an embodiment. It should be furthernoted that the practitioner only needs at this time to utilize one handto manipulate the vial holder 7 as well as support the MVE 1. Thisleaves available the second hand for other tasks.

It should be further noted that the point of the needle 14 is within theoptical path 5 of the MPH 2. Accordingly, the practitioner can move theMVE 1 over the patient's arm 3 viewing the entire vein structure of thepatient. When the practitioner wants to approach a particular vein withthe needle 14, the vein remains within the field of view even as theneedle is brought down the surface of the patient. The prior art systemshad imagers and projectors which were fixedly mounted, and therefore toview large areas of the patients body either the entire projector had tobe move relative to the patient, or the patient had to be moved relativeto the projector.

FIG. 3D show the practitioner inserting the needle 14 of the MVE 1 intothe patient's vein 11. It should be noted that throughout steps 3C and3D only a single hand of the practitioner is required.

FIG. 3E shows the practitioner 6 initiating removal of the MVE 1 fromthe vial holder 7 by squeezing between his thumb and index finger thetop portions of side walls 30 and 31, thereby reducing the pressure uponthe vial holder 7.

FIG. 3F shows the MVE 1 being removed from the vial holder 7. The MVE 1can then be set aside for future use. The practitioner at this point canperform all task normally performed after the vial holder is insertedinto a patient's veins.

The embodiment of FIGS. 3A-3F utilized a standard cylindrical vialholder 7 and relied on pressure between the side arms 30 and 31 to holdthe vial holder in place. Accordingly existing standard vial holders 7can be utilized. It will be appreciated by those skilled in the art thatvial holders having a different cross section than cylindrical can alsobe used by modifying the inside surface of the side arms.

It, however, might be desirable to utilize a new type of vial holderwhich has features that allow it to attach more rigidly to the MVE 1.FIG. 4A illustrates a top view such a new vial holder 40 and the sidearms 42 and 44 of a MVE. The vial holder 40 has four indentations 41,two on one side of the cylindrical body and two directly opposite. Theside arms 42 and 44 of the MVE have four protrusions 43 that areslightly smaller in size than the indentations 41. When the side arms 42and 44 are moved towards the vial holder 40 the protrusions 43 insertinto the indentations 41 and the vial holder 40 is thereby preventedfrom moving in relationship to the MVE.

As a yet further mounting embodiment is shown in FIG. 4B, the side arms47 and 48 can be curved to form the rounded vial opening 8 of FIG. 1.Further the arms are configured with indentations 45, two on each sidearm, which are positioned to receive protrusions 46 which areincorporated into the vial holder 40 of this embodiment. Accordingly,when a vial holder with protrusions as shown in FIG. 4B is utilized, thelocking mechanism between the MVE and the vial is strong due to themating of the protrusions 46 and the indentations 45. Alternatively,when an existing vial holder 7 shown in FIG. 1 is used (without theprotrusions), the unit will function as described in FIG. 1 and thepressure from the curved side arms 47 and 48 against the vial holder 7will hold the MVE and the vial holder together. The indentations 45 inthis case simply will not be used. Accordingly, the an MVE having theside arms shown in this FIG. 4B can be utilized with existing vialholders or can be use with the new vial holder shown in FIG. 4B.

While FIGS. 4A and 4B illustrates mounting arrangements between vialholders and a MVE, the present invention is not limited thereto. Manyother types of removable mounting arrangements can be considered, suchas, for example, the detachable mounting arrangement utilized betweenrazors and razor blades.

Manufactures of the MVE which utilize the new vial holder of FIG. 4A andFIG. 4B will be able to sell a system which contains a single MVE aswell as multiple disposable vial holders 40. Further, a consumablebusiness for disposable vial holders as shown in FIGS. 4A and 4B can beestablished.

FIG. 5A-FIG. 5C shows various views of an alternative mountingembodiment for an MVE. In this embodiment the MVE 50 is connected to astrap 51. In one embodiment the MVE 50 may be connected to a mountingplate 52 which in turn is strapped with strap 51 to the back of the handof the practitioner 6. Preferably, the MVE 50 is rotatably mounted onthe mounting plate 52. The connection rotatable between the MVE 50 andthe mounting plate 52 allows the MVE 50 to be rotated about a first axis53 perpendicular to the back surface of the users hand and also rotateabout a second axis 54 horizontal to the hand. The MPH 2 (not shown) ishoused within the MVE and projects along optical path 5 to field of view4 (in the same manner as described earlier with reference to FIG. 1). Byrotating the MVE 50 on the mounting plate 52 the practitioner can aimthe optical path 5 so that the field of view 4 is positioned around thepoint of the needle 14. FIG. 5B shows a top view of the MVE 50 of thisembodiment. FIG. 5C shows the bottom of the practitioners 6 hand. Thestrap 51 can be attached by Velcro 55 or other suitable means to enablethe practitioner to easily attach and detach the MVE 50.

FIG. 6A shows yet another alternative mounting embodiment for an MVE. Inthis embodiment the MVE 60 is connected to strap 61 which goes aroundthe head of the practitioner 6. The MPH 2 (not shown) is housed withinthe MVE 60 and projects along optical path 5 to field of view 4 (in thesame manner as described earlier with reference to FIG. 1). Thepractitioner 6 can easily move the optical path 5 by moving his head,thereby placing the field of view 4 anywhere desired on the patient.Provided the MVE 60 is positioned so that the optical path 5substantially corresponds with the line of site of the practitioner 6when looking forward, the placement of the field of view 4 on thepatient will be very natural to the practitioner 4. The strap 61 can beattached by Velcro (not shown) or other suitable means to enable thepractitioner to easily attach and detach the MVE 60.

FIG. 6B shows in more detail the MVE 60 of FIG. 6A. The MPH 2 (notshown) is housed in an adjustable housing 62 which is movably connectedto a base 63. In this embodiment, the relationship between theadjustable housing 62 and the base 63 may be that of a ball and socket.The adjustable housing 62 is preferably round and the base 63 is acorresponding concave socket. The practitioner can rotate the adjustablehousing 62 within the base 63 to change the direction of the opticalpath 5 relative to the head of the practitioner. In this manner, themounting of the MVE 60 to the head can be less precise, and optimizationof the direction of the optical path 5 is adjusted by moving theadjustable housing 62 within the base 63. This embodiment leaves bothhands of the practitioner completely unencumbered while allowing thefield of view 4 of the image on the patent to be easily moved by simplehead movements of the practitioner.

FIG. 7 shows yet another embodiment of the MVE which is particularlywell suited for accessing the veins in the arm of a patient 3. Incurrent practice, tourniquets are often placed around the bicep of thearm so as to enlarge the veins of the arm and make them easier to insertneedles into. In this embodiment the MVE 70 is mounted onto a tourniquet71 which gets placed around the bicep of the patient 3. The tourniquet71 can be tightened around the bicep and held tight by e.g., Velcroscraps 72. When tightened around the arm 3, the MVE 70 is oriented suchthat the optical path 5 from the MPH (not shown) housed within the MVE70 is directed towards the target veins 73 on the arm. In this manner,the MVE is held in place and the Practitioner 6 has both hands availablefor use.

FIG. 8 shows another embodiment of the MVE. In this embodiment, the MVE80 is mounted on a generally clear plastic or glass base 81 which can beplaced by the practitioner 6 on the arm of the patient 3. The base 81has a curved bottom 82 which conforms roughly to the shape of the arm ofthe patient 6. Provided the patient 3 does not drastically move theirarm, the MVE 80 will remain in place without requiring the practitionerto hold the MVE 80. If desired, the base may be provided with openingson sides 83 and 84 near the area where the base contact the patient'sarm to receive a strap or other means to secure the MVE to the armwithout unnecessarily blocking the view of the veins. The MPH (notshown) is housed within the MVE 80 and is oriented so that the opticalpath is downward from the MVE to the arm resulting in the field of view4 falling on the patient's arm. The curved bottom 82 is also curvedconcavely inwards so as to provide unobstructed access to the veins ofthe patient with needle 14. In this embodiment, the base 81 needs to berelatively transparent to permit the visual image of the veins projectedfrom the MPH (not shown) within the MVE 80 to pass from the arm of thepatient 6 through the base 81 to the viewer. One advantage of thisembodiment is that, because the MVE 80 is portable, it can be quicklypositioned on patient's arm 3, and can quickly be removed after use andplaced on the side while the practitioner 6 continues their work.

FIG. 9 shows an embodiment of the MVE wherein the MVE 90 is mounted onan adjustable arm 92 which connects on one end to the MVE 90 and at theother end to a base 91. The arm 92 in this embodiment is shown as agooseneck type arm, however other arrangements are possible. The base isshaped so that it can comfortably support the patient's 3 arm. Thegooseneck arm 92 is such it can be moved and rotated by the practitioner6, but after such movement or rotation, it maintains its set position.Gooseneck type arms are well known in the art and need not be describedfurther herein. The MPH 2 (not shown) is housed within the MVE 90 andprojects along optical path 5 to field of view 4. The operation of FIG.9 will now be described. The patient 3 places their arm on the base 91with the elbow facing down. The practitioner 6 turns on the MVE 90 via aswitch (not shown). Alternatively the MVE 90 can turn on automaticallywhen a pressure sensor (not shown) in the base 91 detects the presenceof an arm positioned thereon. The practitioner 6 then moves and rotatesthe MVE 90 until the field of view 4 falls on the desired veins 11, thefield of view 4 remains in a fixed position upon the patient's arm. Thepractitioner may then release the MVE 90, and then go about accessingthe vein 11.

FIG. 10 shows an embodiment that is similar to that of FIG. 9 exceptthat the supporting mechanism 101 is much wider and can support a largerweight. The MPH is housed in the MVE 100 at a position so that theoptical path of the MPH exits through an opening 103. Further, theembodiment of FIG. 10 includes a touch display 102, through which thepractitioner can adjust parameters of the MPH (not shown), such as forexample, the brightness, contrast and the projection angle of the MPH.

FIGS. 11A-11D show an embodiment wherein the MVE 111 removably mounts toan existing phlebotomist's chair 110 having a armrest 112 upon which apatient can rest their arm while the practitioner is accessing theirvein. The MPH (not shown) is mounted in the top portion 113 and projectsalong optical path 5 to field of view 4 which is positioned on thearmrest 112. The top portion 113 mounts to bottom portion 114 in such amanner that the top portion 113 can slide up and down relative to thebottom portion 114, thereby increasing and decreasing the distance fromthe MPH to the armrest 112. As the distance increases the field of view4 grows larger but the brightness at a given location within the fieldof view 4 decreases. Conversely, as the distance decreases the field ofview 4 shrinks but the brightness at a given location within the fieldof view 4 increases.

FIGS. 11C and 11D show in greater detail an example of how the MVE 111can be attached to the armrest 112 of the chair 110. The bottom portionhas a “C” like structure 115 that can be placed over the armrest 112. Ascrew mechanism 116 can be turned to attach the MVE 111 to the armrest112. One skilled in the art will appreciate that there are other typesof means for securing the MVE 111 to the armrest 112.

FIG. 12B shows a prior art vial holder 123 with a prior ail needleprotector 120 connected. When a practitioner is finished with the vialholder 123, prior to disposal, the practitioner uses an availablesurface to push the needle protector 120 down over the needle 124,thereby preventing accidental needle pricks. The needle protector has amain body 121 and a circular mounting ring 122 which fits directly overthe front of the prior art vial holder 123. FIG. 12A shows the prior artneedle protector 120 disconnected from the vial holder 123.

FIGS. 13A-13E shows a needle holder 125 in accordance with the presentinvention that is capable of supporting a MVE. The needle holder 125 hasa main body 126 and a circular mounting ring 127 which fits directlyover the front of a prior art vial holder 123. Additionally, the needleholder also has a thumb support 128 at the base of the needle holder125.

FIG. 13B shows the needle holder 125 of FIG. 13A connected to a priorart vial holder 123 and a MVE 131 temporarily connected to the needleholder 125. A MVE 131 has a main body portion 130 which houses the MPH2. The main body portion 130 is rotationally connected to a stem portion129 in such a manner that the main body portion 130 can be rotated by apractitioner thereby rotating the optical path. 5 up or down. Theconnection between the stem portion 129 and the main body portion 130 isstiff enough that after the practitioner moves main body portion 130 upor down, it remains in that position even after the practitionerreleases the main body portion 130. The stem portion 129 of the MVE 131has an opening at the bottom that is shaped to receive the top of themain body 126 of the needle protector 125. When the stem portion 129 ofthe MVE 131 is placed over the top of the main body 126 of the needleprotector 125 and slight pressure is applied between the two, the twopieces temporarily snap together. The locking mechanism is designed sothat stem portion 129 can rotate while snapped to the top of the mainbody 126. The fitting between the two is tight enough so that after thestem portion 129 is rotated by the practitioner, no further rotationoccurs unless and until the practitioner again rotates the stem portion129.

When the needle protector 125 is attached to the vial holder 123, athumb support 128 is in contact with the vial holder 123. When using thevial holder with the MVE 131 attached, a practitioner would positiontheir thumb on top of the thumb support 128 and their index finger onthe opposite side of the vial (across from the thumb support). In thismanner, the practitioner is supporting in a single hand the vial holder123, the needle protector 125 and the MVE 131. The practitioner can movethe main body portion 130 of the MVE so that the optical path 5 isaligned so that the field of view includes the point of the needle.After the practitioner inserts the vial holder 123 needle into the veinof the patient, the MVE 131 can be detached from the needle protectorand placed down on a surface. At this point in the process, the bloodcan be withdrawn in the same manner as the prior art system of FIG. 12B.Upon completion of activity, the vial holder 123 and the needleprotector 125 can be disposed of.

FIGS. 14A and 14B show an embodiment wherein the MPH 2 is integratedinto a magnifying glass housing 143 which supports a magnifying glass140. The magnifying glass housing 143 connects, for example via agooseneck or other type support 141 to a clamp 144 which in turn canmount to a table, the arm of a phlebotomist chair or other suitablesupport. The MPH 2 is positioned within the magnifying glass housing 143such that the optical path 5 is aimed downward towards the table or armof the chair. When a patient 3 places their arm on the table the fieldof view 4 falls upon the arm. As shown in FIG. 14A, when thepractitioner looks through the magnifying glass 140, an enlarged image145 of the vial holder 142 and the veins of the patient 3 within thefield of view 4 of the patient is provided. Viewing the enlarged imagepermits greater accuracy in inserting the vial holder into the veins ofthe patient.

As a yet further embodiment, the magnifying glass 142 of FIGS. 14A and14B can be replaced with a flat panel display. In this case the MPH 2only has to capture the image of the veins and the needle of the vialholder 142 within the field of view 4 and does not have to retransmit avisible image onto the arm. Instead, the visible image of the veins andthe needle is transmitted onto the flat panel display 142 which isviewed by the practitioner as he inserts the needle into the vein. Inthis embodiment, the practitioner is not directly viewing the needle orthe arm but instead is viewing an image thereof in the flat paneldisplay 142. The image in the flat panel can digitally be enlarged orreduced (zooming) as required by the practitioner. The controls for suchzooming can be via touch screen input onto the flat panel display.

FIGS. 14C and 14D show two perspectives of yet another embodiment of anMVE 150. In this embodiment the MVE 150 includes a small display 151,which is viewed along viewing angle 157 by the practitioner, havingattached thereto an attachment piece 154 and a MPH 2. Although theattachment is shown at a right angle to the stem extending verticallyfrom the vial, the stem can be at an angle to the vial and the displayangle can vary, as well. A needle protector 156, similar to that shownin detail in FIG. 13A connects to a vial holder 7. The attachment piece154 receives the top of the needle protector and temporarily locks theMVE to the needle protector 156 which in turn attaches to the vialholder 7. The MPH 2 is attached to the small display 151 and is orientedso that the optical path 5 is such that the field of view 4 covers thepoint of the needle 14. The MPH 2 outputs the image of the veins 11 ontothe field of view 4 on the patient (not shown). The MPH 2 also providesthe image signal to the display 151 to be viewed on the display 151. Theimage signal includes both the veins and the needle 14. The display 151includes image processing capabilities that detects the position of thetip of the needle and displays a predetermined number of pixels of theimage around the tip of the needle on the display. In FIG. 14C, both theimage of the needle 153 and the image of the vein 152 are shown.

An example of using the MVE 150 of FIG. 14C follows. A practitionerselects a disposable sterile vial holder 155 which has the needleprotector 156 attached thereto. The needle protector 156 is moved toright angle position relative to the needle 14, thereby exposing theneedle. The MVE 150 is connected via the attachment piece 154 to the topof the needle protector 156. The MVE is then turned on and the MPH 2receives the image of the veins 11 and the needle 14 within the field ofview 4. The practitioner would move the MVE 150 about the patientviewing the image of the veins 11 projected onto the patient. The imageof the veins will be the actual size and position of the patient'sveins. When a vein is selected for puncture with the needle, thepractitioner will bring the needle towards the vein while still viewingthe image of the veins on the patient body. When the practitioner getsclose to the selected vein with the point of the needle, thepractitioner will look at the display 151 image which is an enlargedimage of the point of the needle 153 and the target vein 152. By usingthis enlarged image, the practitioner can be certain to puncture thecenter of the vein 11 with the needle 14.

The display 151 can be very small given that all it has to do is showthe amplified view of a single vein and the needle. By way of example,as shown in FIGS. 28A and 28B, wherein FIG. 28A represents the image ofthe veins 11 on the patient in the field of view 4, and FIG. 28Brepresents the image of the vein 152 and the image of the needle 153displayed on the display 151. In this example, the target vein is 0.10inch across and the field of view 4 is 3″ by 3″, and the resolution ofthe image captured and projected by the MPH 2 in the field of view is1000 pixels by 1000 pixels. In this example, the MVE is programmed todisplay on the display 151 a 300 pixel by 300 pixel area having theneedle centered therein. Referring to FIG. 28B, the resulting amplifiedimage of the vein 152 is shown at more than three times its originalwidth. As can be appreciated, the amount of magnification (zoom amount)on the display 151 can be algorithmically adjusted by a processor in thedisplay. Inputs can be provided for the practitioner to select theappropriate gain amount.

An alternative embodiment is shown in FIG. 14E wherein the display 151of FIGS. 14C and 14D is replaced by a rear projection screen 158. TheMPH can be configured to project a split image. The bottom half is theactual image representing the veins 11 and the top half is an image ofthe magnified image of the veins and needle. A mirror 159 is placedwithin the optical path 5 of the top half of the image projected by theMPH 2. The mirror 159 is angle so that the top half of the image isprojected along optical path 5B to the rear projection screen 158. Rearprojection screen is translucent and can be viewed by the practitioneralong viewing angle 157. In this manner, a display screen is obtainedwithout incurring the addition cost, size and power of the dedicateddisplay of FIG. 14C and FIG. 14D.

In still another embodiment, as seen in FIGS. 15a-15d , the MVE may havea disposable stand 200, which may include a generally “C” shaped baseclip portion 201. Base 201 may be constructed from the same materials asthe previously mentioned embodiments. In the preferred embodiment MVEstand 200 can be molded from a clear plastic. Any suitable clear plasticknown in the art including but not limited to PVC, Polystyrene, Acrylicand the like may be used. Extending from base 201 may be an arm 202,which has a concave bottom corner 203 and a convex top corner 204. Bothcorners may be integrally formed with base 201. Arm 202 may have aninside surface 205 and an outside surface 206. Located between topcorner 204 and bottom corner 203 of arm 202 may be a second generally“C” shaped clip 209. Located at the top of MVE 200 may be a generallycircular ring portion 207. Ring portion 207 may be an integral member ofMVE stand 200 or ring 207 may be a separately attached member. In apreferred embodiment ring 207 was integrally formed with stand 200. Inaddition, ring 207 may have a generally circular threaded outer topsurface, so as to act as a male end, or ring 207 may have a generallycircular grooved inner surface, so as to act as a female end, a utilityof which will now be discussed.

With the present embodiment MPH 208 will operate as in the previousdiscussed embodiments, however in the present embodiment MPH 208 mayhave either a threaded outside surface or a grooved inside surface, thiswill be a matter of preference. For example, if ring 207 has a threadedoutside surface MPH 208 will have a corresponding grooved insidesurface, this will give the practitioner the ability to attach andremove the MPH, before and after use, respectively. In normal operationthe practitioner will snap clip 201 to prior art vial 220. In addition,the practitioner will snap clip 209 to prior art needle protector 221.After the clips 201 and 209 have been attached the practitioner may thenattach MPH 208 to ring 207. This will be accomplished via the twoprevious attachment methods already discussed. It should be pointed outthat the practitioner may also attach MPH 208 to ring 207 beforeattaching the rings to the vial.

Once the MVE is securely attached the practitioner may then continuewith the procedure as previously discussed. After the procedure iscomplete the practitioner will then apply a pressure to surface 206sufficient enough to push needle protector 221 and arm 202 over the usedneedle 223, after which the MPH may be removed for future use and theneedle and MVE stand 200 may be discarded.

Another embodiment of a disposable MVE stand 302 may be seen in FIGS.16a-16c . This type of embodiment may include a MPH 301, a stand 302 anda vial 303. MPH 301 may have the same operable features as previousmentioned MPHs. Stand 302 may be constructed of any suitable knownmaterial in the art including but not limited to metal, metal alloy,plastic, plastic composite, or the like. In a preferred embodiment stand302 can be made of plastic. Plastic was preferred because of costeffectiveness and sanitary qualities. As mentioned above MPH 301 mayoperate as in the other previous mentioned embodiments, however uniqueto the present embodiment are carriages 304 and 304 a located on MPH 301and vial 303, respectively. Carriage 304 may be any suitable shape knownin the art, in a preferred embodiment carriage 304 has a generallyrectangular shape. In addition, carriage 304 may have an orifice 307extending from a front end 305 to a rear end 306, or partiallytherethrough. In a preferred embodiment orifice 307 does not extend theentire length of carriage 304, as seen in FIG. 23a . Orifice 307 mayhave a diameter that is slightly smaller than holder portion 309 ofstand 302. Stand 302 may have also have a keeper portion 310. It shouldbe pointed out that keeper 310 and holder 309, as seen in FIGS. 23b and23c , are generally the same shape and size as each other and in thepreferred embodiment may be used interchangeably.

Located on at least one side of vial 303 may be another carriage 304 a,as mentioned above. In a preferred embodiment carriage 304 a may begenerally the same size and shape as carriage 304. However, one mayimplement different sizes and shapes for any of the carriages and/orarms. Carriage 304 a may also have an orifice 307 a that extends from afront end 305 a to rear end 306 a, as in carriage 304. In the preferredembodiment both carriages have orifices that extend equally the samelength. One difference between carriage 304 and 304 a is that carriage304 is slightly rounded, so as to conform to MPH 301. In anotherembodiment MPH may have a straight base, in which case carriage 304 maynot be rounded. Carriages 304 and 304 a may be located anywhere on MPH301 and vial 303, respectively. In normal operation the practitioner mayinsert holder arm 309 into orifice 307 and keeper arm 310 into orifice307 a. Once inserted the practitioner may move the MVE to the desiredposition. Since the individual carriage orifices have smaller diametersthan the respective arms that they receive, the relied upon pressurewill keep the MPH from moving during the procedure.

Drawing ones attention now to the drawings labeled FIGS. 17a-17d isanother embodiment of the present invention. In this embodiment, the MPH401 operates in generally the same manner as the previous mentionedembodiments. A unique feature of this embodiment is the mounting bracket400, which acts as a needle cover too. Mounting bracket 400 may includeda mast portion 402 and a ring portion 403 that is hinged to mast 402.Ring portion 403 may be generally circular in shape with a front surface404 and a rear surface 405. Also, ring portion 403 may have an orifice406 that may extend from front surface 404 to rear surface 405, as seenin FIGS. 24a -24 c.

Orifice 406 may be defined by inner circumferential wall 407. Orifice406 of ring 403 may be sized to receive neck 408 of vial holder 409. Inaddition orifice 406 should have a diameter that will allow ring 403 tosnap onto neck 408 of vial 409, this will allow the practitioner toattach bracket 400 before the procedure and dispose of bracket 400 afterthe procedure is performed, i.e. a disposable bracket. Ring 403 may alsohave a generally flat top surface 410. Flat top surface 410 may includesa break-away support diaphragm 411 that provides fore and aft stability,as seen in FIG. 17b . Also located on top surface 410 may be a livinghinge 412, which provides side to side stability.

Hinge 412 may be any suitable type of hinge known in the art, in thepreferred embodiment there can be a flexible plastic strip that connectsring 403 to mast 402. In addition, located on top surface 410 may be alocking mechanism that keeps mast 402 in an upright position when thepractitioner is inserting the needle into the patient's arm andthereafter when the practitioner is drawing blood from the patient. Asmentioned above, mast 402 may also act as a needle cover, and as suchshould be shaped and sized so as to be able to completely cover theneedle 413 before and after use. Also mast 402 should be sized andshaped to be able to snuggly receive a bottom portion 414 of MPH 401.Mast 402 and ring 403 may be integrally formed or separately attachedmembers. In the preferred embodiment mast 402 and ring 403 wereintegrally formed.

In normal operation the practitioner would snap ring 403 to neck 408 ofvial 409. After ring 403 is securely attached to vial 409 thepractitioner may lift mast 402 to an extended position so as to exposeneedle 413. Mast 402 will remain in a secured upright position vialocking hinge 410. Once needle 413 is exposed the practitioner may thenattach MPH 401 to mast 402. After MPH 401 is attached, the practitionermay then operate the MVE as in any of the previous embodiments.

For extra support there can also be a support ring 420 used forstabilizing mast 402 and MPH 401, as seen in FIGS. 18a-18b . In thisembodiment support ring 420, may be defined as semi-circular, with aright arm 421 and a left arm 422 extending from a top area. Support ring420 may also have an outer surface 423 that may extend from right arm421 to left arm 422, and a inner surface 424 that also may extend fromright arm 421 to left arm 422, as seen in FIG. 18c . Located on innersurface 424 of arms 421 and 422 may be two detents, 425 and 426respectively. Detents 425 and 426 may be generally circular in shape andmay extend from inner surface 424 to outer surface 425, so as to formtwo orifices, as in the present invention. Conversely, detents 425 and426 may only extend partially into inner surface 424, so as to form twobored cavities.

As previously discussed MVE may also have a mast 427 and a ring 428,which may, as in a preferred embodiment, or may not be hinged to mast427. In this embodiment support ring 420 pivotally attaches to mast 427,this may be achieved via two generally circular dimples 429 and 430located on the outside surface 431 of mast 427. Detents 425 and 426 anddimples 429 and 430 may be centrally aligned along the same axis ofrotation so as to allow for pivotal movement of mast 427. In normaloperation the practitioner will snap on support ring 420 to neck 433, asin the previously discussed embodiment. The practitioner may then attachring portion 428 to neck 433, after which, dimples 429 and 430 may beinserted into detents 425 and 426. Lastly MPH 401 may then be connectedto mast 427. Once all members are attached the practitioner may thenoperate the MVE as in all previous embodiments.

In another embodiment, as depicted in FIGS. 19a-19d , vial 460 may havetwo generally cylindrical pegs, right peg 462 and left peg 463, locatedon its upper front surface just above neck 461. Peg 462 may have anouter and inner surface, 462 a and 462 b, respectively. Peg 463 may alsohave an outer and inner surface, 463 a and 463 b, respectively. Peg 462may have an orifice 462 c that extends from inner surface 462 a to outersurface 462 b, or orifice 462 c may extend only partially into peg 462.Peg 463 may have a similar orifice. In this embodiment there can also bea mast 464 that may have a broader top portion 464 a and a narrowerbottom portion 464 b. Top portion 464 a may be generally the same sizeand shape as the previous mentioned embodiments, and as in all otherembodiments top portion 464 a has a slit that has a length equal to orgreater than needle 413.

In the present embodiment a key feature of mast 464 is the generallycylindrical bottom member 464 b. Located on the outer side surfaces ofbottom portion 464 b may be two dimples, 464 c and 464 d, which extendoutwardly in a generally perpendicular direction. The present embodimentmay also implement a support ring 465, as in the previously discussedembodiments, which may be used to stabilize mast 464 and MPH 467.Support ring 465 may be generally circular in shape with a diameter thatis slightly larger than neck 461. This arrangement will allow for a snugfit and still allow support ring 465 to rotate a locked and unlockedposition, as seen in FIG. 19b . In addition support ring 465 may have atleast one side bar 465 b extending perpendicular from generally outercircumferential surface 465 a. In a preferred embodiment there can betwo side bars, 465 a and 465 b, extending perpendicularly generallycircumferential outer surface 465 a, as seen in FIG. 19d . Also, thepreferred embodiment may have a support post 465 d. Support post 465 dmay extend outwardly, preferably perpendicularly from outer surface 465a and may be located near the top of ring 465. Support post 465 d mayhave a width that is equal to, less than, or greater than mast 464preference. Located on the top portion of support post 465 may beplatform 465 e used to maintain mast 464 in an upright position. Supportpost 465 may have a length so as to allow support post 465 to fitsnuggly under bottom surface 464 f. In normal operation the practitionermay attach mast 464 to vial 460. Once mast 464 is attached, support ring465 may then be snapped onto neck 461 of vial 460. At which time MPH maythen be attached to mast 464 and support post 465 e placed in a lockedposition. After the practitioner is finished performing the venouspuncture procedure, the practitioner may then rotate support ring 465 toan unlocked position and place mast 464 over needle 413.

In still another embodiment as seen in the drawings labeled FIGS. 20aand 20b , the MVE 500 may include a needle protector 501, a mountingbracket 502, a needle 503 and a MPH 504. Needle cover 501 may be sizedand shaped as in the other previous discussed embodiments. One keydistinction however, is the placement of needle cover 501. In thepresent embodiment needle cover 501 may be placed on either the right orleft side of vial 506. In the preferred embodiment needle cover 501 islocated on the right side of vial 506, as seen in FIGS. 20a-20b . Needlecover 501 may have also have a bottom ring member 520 that is hinged toa top member 521. Ring 520 may have a diameter so as to allow thepractitioner to press fit the needle protector over neck 507 of vial506. Ring 520 may be hinged to top member as in the previous mentionedembodiments.

Another key distinction in the present embodiment is mounting bracket502. Mounting bracket 502 may be constructed of any suitable materialknown in the art including, but not limited to metal, metal alloy andthe like. In the preferred embodiment mounting bracket 502 wasconstructed from medium strength plastic. Mounting bracket 502 may bedefined as having a top surface 508 and a bottom surface 509 connectedby a generally circumferential sidewall 510, as seen in FIG. 20a .Mounting bracket 502 may have a generally “C” shape, with two orifices513 and 514 located near a front end 511 and a rear end 512respectively. Orifice 513 is generally circular in shape having adiameter sized so as to be able to receive a portion of MPH 504. In apreferred embodiment inner circumferential wall 515 may be designed sothat MPH 504 may be secured to mounting bracket 502 by a press fit, orin another embodiment orifice 513 may have a threaded innercircumferential wall 515 so that a portion of MPH may be screwed toinner circumferential wall 515. In addition there can be a clear lensshield that can keep blood off of MPH 504. Orifice 514 may be sized andshaped so as to be able to receive neck 507 of vial 506.

Mounting bracket 502 may be press fitted to neck 507. This press fitallows the practitioner to rotate mounting bracket 502 30 degrees to theleft or right, thus, if the practitioner should encounter any visualobstructions during the venous penetration and/or extraction, thepractitioner may simply rotate mounting bracket 502. In anotherembodiment mounting bracket 502 may be integrally formed with vial 506,as in the preferred embodiment. In this embodiment mounting bracket maybe designed to rotate in a similar manner as in the press fittedmounting bracket. In normal operation the practitioner may snap MPH 504into orifice 515. Once MPH 504 is securely attached the practitioner maythen rotate mounting bracket 502 up to 30° left or right, if needed.Also, the practitioner may attach needle cover 501 to neck 507. Afterthe practitioner has performed the venous penetration and/or extraction,the practitioner may then place needle cover 501 over needle 503, removeMPH 504 from mounting bracket 502 and then dispose of syringe.

In another embodiment the MVE may include a MPH 550, bracket 560 andvial 570, as seen in FIG. 21a . This embodiment is similar to previousembodiments, however in this embodiment MPH 550 may have a mountinggroove 551. Mounting groove 551 may be any suitable shape known in theart including but not limited to a square, rectangle and the like. Inthe preferred embodiment a generally rectangular groove was implemented.One could also have a mounting bracket with more then one groove. Forexample there can be two rectangular grooves. Mounting bracket 560 maybe integrally formed with vial 570 or mounting bracket 560 may be aseparately attached member. In a preferred embodiment, the mountingbracket was press fitted, which allowed the practitioner to dispose ofthe syringe after use. In another embodiment, mounting bracket 560 maybe screwed on, and in another embodiment mounting bracket 560 may bebonded to vial 570, via any suitable bonding method known in the art.Mounting bracket 560 may have a generally upside down “L” shape, whenlooking at it from a side view, that is bent toward the bottom, as seenin FIG. 21b . Located near the top of bracket 560 may be two bracketfingers, left finger 561 and right finger 562. Fingers 561 and 562 havea generally “C” shape, when looking at them from the front, top, orbottom view. Fingers 561 and 562 are separated by a distance that willallow MPH 550 to be securely snapped into place. Mounting bracket 560may also have front and rear surfaces, 563 and 564 respectively,connected by right and left sidewalls 565 and 566 respectively. Locatedon surface 563 may be groove 563 a. Groove 563 a may extend from rightsidewall 565 to left sidewall 566, or partially therethrough. Groove 563a may be used to secure an optionally removable disposable shield. Theneedle 571 and needle cover 572 may be similar to the needle cover andneedle of previous discussed embodiments.

Other embodiments of the present invention include hand held versions asseen in FIGS. 22-27. In these embodiments the MPH will operate insimilar fashion as previously discussed. Also, in the hand heldembodiments, there may be a main body that houses a first batterysource, and a cavity in the MPH that houses a separate second batterysource. With this configuration the first battery source may act as acharger for the second battery source, when connected, thus allowing thepractitioner to remove and use the MPH from the main body when desired.Furthermore, there can be a separate AC charger, similar to that usedwith cell phones and the like, that can be used to charge any of thehand held versions of the present invention. In addition, the needlecover will also operate in similar fashion as previously discussed. Themain distinctions between the previous discussed embodiments and theembodiments of FIGS. 22-27 are the mounting techniques and/or addedattachments. For example, drawing one's attention to FIGS. 22a-22e is aMVE that implements a knurled cap 601, located on body 602 of MPH 600,for battery access. With this embodiment body 602 of MPH 600 may beconstructed of any suitable material in the art including but notlimited to metal, plastic and the like. In a preferred embodiment, body602 can be made of a thermoplastic rubber. Also, there can be a holder604 that fits on needle cover 603. Holder 604 may be constructed of anysuitable material known in the art, in the present invention holder 604was constructed of plastic. In addition, holder 604 may be generally “C”shaped so as to be able to receive a portion of body 602. In normaloperation the practitioner may hold MVE between the forefinger andthumb, or the practitioner may connect the MPH of MVE to vial 608 viaholder 604. The operation of the MVE is generally the same no matterwhich method of use is implanted, that is to say the practitioner willpoint the front end of MPH in the direction of venous penetration and/orextraction.

In another hand held embodiment of the present invention, as seen inFIGS. 23a-23d , the holder 680 may have a generally polygonal shape, anda corresponding polygonal body 681, any suitable polygonal shape knownin the art including but not limited to a hexagon, pentagon and the likemay be used. In a preferred embodiment, holder has a hexagonal shape andbody 681 has a corresponding hexagonal shape. Holder 680 may also have abottom portion 680 a used to secure holder 680 to needle cover 685.Bottom portion 680 a may be generally cylindrical in shape with ahollowed out center, this allows the practitioner place holder 680 overand around needle cover 685. Also, there can be a string 682 located ata rear end, for hand held use. The string can be made of any type ofmaterial known in the art including but not limited to nylon, plastic,and the like. In a preferred embodiment a lanyard was implemented. Innormal operation the practitioner may place holder 680 over needle cover685. After the holder is securely attached to needle cover 685 thepractitioner may then slide body 681 of MPH 690 through hexagonal holder680. This embodiment also may be hand held.

Drawing one's attention to FIGS. 24a-24i is another embodiment of thepresent invention. In this embodiment the MPH 690 may be attached to thefront end of a flashlight for hand held use. Alternatively, the MPH maybe attached to needle cover 691 as in previously discussed embodiments.This embodiment may also implement a ring 692, which may be used tosecure MVE to a key chain or the like.

In another embodiment, the MPH 701 of the MVE 700 may be contained in anoval housing, as seen in FIGS. 25a-25d . In this embodiment, the housingmay have a top, generally, oval surface 702 and a bottom, generally,oval surface 703. Both top surface 702 and bottom surface 703 may besnap fitted to form MVE 700. Both top surface 702 and bottom surface 703may be constructed from any suitable material. Located on top surface702 may be switch panel 704. Switch panel 704 may be made from the samematerial as top and bottom surfaces 702 and 703 respectively, or switch704 may be made of a rubber, as in the preferred embodiment. Switch 704may be designed to turn the MVE “on and off” via a pressing motion or asliding motion. Switch 704 may have bored grooves 706 used to facilitatethe sliding of switch 704, or switch 704 may have ribs located on switch704, also used to facilitate sliding. In a preferred embodiment eithertop surface 702 or bottom surface 703 may have an outer generally ovalgroove 709. Groove 709 may be used to secure MVE to a vial or syringe,as seen in FIG. 25c . Located on bottom surface 703 may be a flexibleclip 707. Clip 707 may be integrally formed with bottom surface 703, inwhich case clip 707 may be constructed from the same material as bottomsurface 703. Conversely clip 707 may be a separate member attached toeither bottom surface 703 or top surface 702, in which case clip 707 maybe constructed of any suitable material known in the art. In a preferredembodiment, clip 707 was integrally formed with bottom surface 703. Clip707 may be used to secure MVE 700 to the shirt pocket, or the like, of apractitioner. This will give the practitioner easy quick access to theMVE. Bottom surface 703 may slope in an upwards fashion near the frontend of bottom surface 703, as seen in FIGS. 25a-25d . Located near thefront end of bottom surface 703 may be a generally rectangular opening708. In a preferred embodiment, MPH 701 may be set inside of the housingand have its front face even with the plane of surface 703. In anotherembodiment, MPH 701 may have its front face raised above the plane ofsurface 703, and in a third embodiment MPH 701 may have it's front facerecessed below the plane of surface 703. As mentioned previously, thisembodiment of the MVE may be hand held or attached to a vial, as inother embodiments. This arrangement may be observed on FIGS. 25c and 25d. If the latter method of use is used, i.e. attached to a vial, theneedle cover 710 may have a generally rectangular top portion 711 thathas a width larger enough to receive the MVE. In addition, located onthe inside of top portion 711 may be at least one tongue portion 712, asseen in FIG. 32d , used to mate with groove 709. Conversely, there canbe at least one groove on an inside surface of top portion 711, andeither top or bottom surface, 702 and 703 respectively, may have anouter generally oval tongue. Operation of this embodiment is similar toprevious mentioned embodiments.

Two additional embodiments of the present invention may be seen in FIGS.26a-27d . First, the embodiment depicted in FIGS. 26a-26d . Thisembodiment includes a MPH that may be either hand held, as seen in FIG.26d , or mounted on to a needle cover 802, as seen in FIG. 26b . In thelatter configuration, the operation of the mounting of MPH is similar tothe other previous embodiments. The MPH has an adjustable rear end 801that may have an orifice 803 to receive top portion 804 of needle cover802. In the hand held configuration, rear end 801 of MPH 805 may beslidably attached to a battery holder 810. In this embodiment, batteryholder 810 may be generally pear shaped with a wider rear end 811 and atapered front end 812. Located near front end 812 may be a boredgenerally rectangular slot 813. Located inside of slot 813 may be atleast one contact. Rear end 804 of MPH 805 may be generally the sameshape as bored slot 813. Also, located on a surface of rear end 804 maybe at least one contact. In normal operation the practitioner may sliderear end 804 from either the left or right side or insert rear end 804of MPH 805 into slot 813 from the front end.

Similar to the just mentioned embodiment is the embodiment depicted inFIGS. 27a-27d . This embodiment includes a MPH that may be either handheld, as seen in FIG. 27d , or mounted to a needle cover 902, as seen inFIG. 27b . In the latter configuration, the operation of the mounting ofMPH is similar to the other previous embodiments. The MPH may have anorifice 903 to receive top portion 904 of needle cover 902. In the handheld configuration, rear end 901 of MPH 905 may be slidably attached toa battery holder 910. In this embodiment battery holder may be generallyrectangular in shape. Located near front end 912 may be a boredgenerally rectangular slot 913. Located inside of slot 913 may be atleast one contact. Rear end 904 of MPH 905 may be generally the sameshape as bored slot 913, also located on a surface of rear end 904 maybe at least one contact. In normal operation the practitioner may sliderear end 904 into top slot 913.

The MPH 2 will now be described. FIG. 29 shows a prior art scanninglaser-based camera (hereinafter SLBC) 170 of Microvision, Inc. FIG. 17is taken from Microvision's website:(http://www.microvision.com/technology/imaging_works.html) dated Jan. 7,2006, herein incorporated by reference. The SLBC 170 includes a lasersource 171 which gets reflected off mirror 172 to a MEMS scanner 173.The MEMS scanner 173 has a reflective surface that can be oscillated inboth the X and Y axis. The oscillation of the MEMS scanner 173 iscontrolled by electronics (not shown) so that the reflected laser beamis moved in a raster pattern. To create a color camera, the laser sourceis a combination of a red, green and blue laser, thereby forming thecolor white. Three photodetectors, one responsive to red 175R, oneresponsive to blue 175B, and one responsive to green 175G are positionedon the SLBC 170 and receive the rastered laser light reflected offobject 176. The output of the photodetectors 175R, 175B, and 175Bprovide an analog rastered image representative of the object 176. Theoutputs of the photodetectors are converted from an analog signal to adigital signal by D/A converters (not shown). A controller (not shown)determines the instantaneous rastered laser light position and convertsthat to an appropriate pixel location. The controller then and writesthe digitized RGB values to an appropriate pixel memory location. Byrepeating this step for each pixel location, a digitized version of theobject is stored in memory. Each raster sweep of the field of view 4results in a new image being stored. By sweeping at video rates, videoimages can be captured.

A publication in Laser Focus World, December 2004, authored by ChrisWiklof, entitled “Display technology spawns laser camera”, hereinincorporated by reference, describes the SLBC of FIG. 29 in even greaterdetail.

FIG. 30 illustrates an embodiment of the MPH 2 in accordance with thepresent invention. A single colored laser 180, for example a 630 nmsemiconductor red laser, is projected into combiner 181. A semiconductorlaser 183 is also projected into the combiner 181. Laser 183 may have awavelength from 700 nm to 1000 nm with a preferred wavelength of 740 nm.An illustrative example of a semiconductor 740 nm laser is SacherLasertechnik's Fabry Perot Diode Laser 740 nm, 10 mw, model numberFP-0740-10. The combiner 181 outputs a combined laser beam 184 which isthe combination of the 630 nm red and the 740 nm laser beams. Combinersfor combining two lasers of different frequencies are well known in theart and will not be further described herein. The combined laser beam184 is positioned to hit off mirror 172 and then to hit the MEMS scanner173. The MEMS scanner moves in a raster pattern thereby causing thecombined laser beam to move along optical path 5 forming a rasterpattern at the field of view 4. A photodetector 182 which is responsiveto the 740 nm wavelength is provided and receives 740 nm light reflectedoff objects in the field of view. The photodetector 182 outputs ananalog signal representing the amount of 740 nm light received. Anillustrative example of a photodetector is Roithner Lasertechnik's modelnumber EPD-740-1.

FIG. 31 shows a control block diagram for controlling the elements inFIG. 30. A first mode of operation which will be referred to hereinafteras an “Alternating Frame Mode” (AFM) follows.

In the AFM mode, an electronic block 192 for driving the MEMS driver andfor sensing the position of the raster scanner is provided 192. Thisblock generates the signals required to drive the MEMS scanner 173 in araster pattern, and also determines the exact instantaneous location ofthe MEMS scanner and communicates this information to an image memory191. This electronic block 192 also generates output signals andindicates whether the current frame (a frame is a complete raster of thefield of view) is an odd number Frame 1 or an even number Frame 2(essentially the two signals are opposite and switch polarity everyother frame). The operation is as follows. The MEMS 173 is driven in araster pattern. The first full frame after achieving a stable rasterpattern will be identified as an odd number frame and the laser driver195 for the 740 nm laser 183 is turned on for the entire frame. Duringthis time the laser drive 194 for the 630 nm laser is turned off. Thelight from the 740 nm is absorbed by the veins in a patient's body andreflected by the skin of the patient, thus forming a contrasted imagethat is then sensed and converted into an analog signal by 740 nmphotodetector 182. The analog signal is then passed through an A/Dconverter 190 which outputs a digital representation to image memory191. Image memory 191 also receives instantaneous position informationfrom the electronic block 192, and based upon such information, thedigital representation is stored in a memory location corresponding to aparticular pixel. This is repeated for each pixel within the odd frame.Upon completion of the odd frame, the image memory contains the image ofthe veins within the field of view of the MPH. During the even numberframe, the laser driver 195 to the 740 nm laser is turned off. The datain the image memory 191 is read out as a function of the instantaneousposition information provide by the electronic block 192 and provide toa D/A converter 193 which outputs an analog signal to laser drive 194which drives the 630 nm laser. In this manner, the image that was storedin the odd number frame is projected by the 630 nm laser 180 in the evennumber frame. In this manner, the veins that are in the field of viewbecome visible to the practitioner.

A second mode of operation is shown in FIG. 32. This mode shall bereferred to hereinafter as the “Dual Buffer Mode” (DBM). In the DBM, asecond image memory called image memory two 196 is added. In the DBM,the laser driver to the 740 nm laser is turned on for every frame and ineach frame the image of the veins is captured and stored in image memory191 exactly as described previously in the AFM mode. However, in thiscase the electronic block 192 provides an end of frame indication toboth image memory two 196 and image memory 191 which causes the entireimage stored in the image memory 191 to be transferred to image memorytwo 196 during the blanking time of the raster scan (the time after theraster scan is completed but before the next raster scan starts). Duringthe next frame, the contents of image memory two 196 is then projectedby the 630 nm laser onto the field of view. In this manner, the visibleimage projected is always on frame behind the actual image captured.Provided the frame rate is fast enough, this delay should not beapparent to the practitioner. Frame rates in excess of 30 frames persecond can easily be achieved with the MEMS scanner provided herein.

The DBM mode is advantaged as compared to the AFM in that the visiblelaser is on every frame, and therefore is twice as bright. However, theAFM mode is advantaged in that it only requires a single memory bufferand therefore is more cost effective than the DBM mode.

A third mode of operation is illustrated in FIG. 33. This mode shall bereferred to hereinafter as the “Real Time Mode” (RTM). In the RTM theMEMS 173 is driven in a raster pattern by a MEMS driver 210. The laserdriver 195 to the 740 nm laser is turned on all the time. The reflectedlight is received by the 740 nm photodetector 182 and the analog signalproduced is connected to the laser driver 194 for the 630 nm laser 180.In this manner the red laser 180 projects nearly instantaneously thesignal that is being received by the photodetector 182. The only delayis dictated by the speed of the photodetector and the laser drive 194circuitry. Accordingly, there is no need for an image memory buffer andassociated DIA converters and A/D converters. Further, since the imageis never stored, there is no requirement to sense the instantaneousposition of the laser for the purpose of clocking the image into memoryor for projecting the visible image. In fact, in this RTM, the rasterpattern does not need to be as steady and repeatable as that of theother modes, thereby possibly decreasing the complexity and cost of theMEMS and associated drive circuitry.

The RTM is so forgiving of the scan pattern that practically any densescanning pattern can be utilized, for example, a two dimensional movingmirror is provided by Fraunhofer IPMS. In a press release dated Jan. 3,2005 they described a two dimensional mirror as follows:

-   -   “Projection devices based on laser scanning are a very        interesting alternative to matrix displays. A modulated laser        and a deflection unit are necessary. Using micro scanning        mirrors for implementing the laser beam deflection in a        projection device has many advantages. In particular, micro        scanning mirrors, which operate resonantly in both directions,        enable the development of systems with very small size, high        deflection angles with low voltage and low power consumption.        The presented demonstrator uses a commercial laser module and a        2D micro scanning mirror operated with deflection frequencies of        9.4 kHz and 1.4 kHz. The device uses both axes to perform a        sinusoidal oscillation, which causes a beam trajectory that        describes a Lissajous pattern with high density, instead of the        usually implemented linear scanning. Therefore, mirrors with low        ratio of horizontal and vertical deflection frequency can be        used. This kind of micro scanning mirrors can be fabricated        easily and cost effective. The control circuit is developed with        an FPGA and provides a resolution of 256×256 monochromatic        pixels. Programmable counters are used for generating the mirror        driving signals and for determining the beam position. Mirror        excitation and image synchronization work without feedback loop.        This means, no complicated optical or electronic synchronization        techniques are needed. This simplifies micro scanning mirror and        control circuit and enables low cost production. Applications of        the projection device are displays, laser marking and laser        exposure.”

In the RIM of FIG. 33, the MEMS could be replaced by the two-dimensionalmirror of Fraunhofer IPMS which creates a Lissajous pattern with highdensity instead of the raster pattern. The visible laser will simplyfollow nearly instantaneously the image detected by the 740 nm laserdetector.

In the embodiments herein the visible light transmitted was a red laser.However, any visible color or combination of color could be transmitted.For example, three laser RGB could be utilized to transmit full colorimages onto the field of view.

While in the embodiments herein a single two-dimensional mirror whichmoves in two axis was used for steering the beam, other beam steeringarrangements could be used. For example, the outgoing laser beams can bebounced first off a one dimensional high speed scanning mirror and thenoff a second lower speed mirror scanning in the opposite direction.There are many other methods known to those skilled in the art forcreating raster and other scanned laser patterns.

While many of the embodiments described herein utilized vial holderswith needles, there are many other medical procedures which need to viewthe veins. The invention is not intended to be limited to devices whichattach to vial holders.

What is claimed is:
 1. A miniature vein enhancer, for use in imaging the subcutaneous veins of a target area of a patient by a practitioner, said miniature vein enhancer comprising: a miniature projection head, said miniature projection head comprising means for imaging subcutaneous veins of the target area and for projecting said image onto the target area to overlie the subcutaneous veins, said miniature projection head comprising a housing configured to receive said means for imaging and projecting, said housing comprising an opening, an optical path of said means for imaging and projecting being through said opening in said housing; said miniature vein enhancer comprising a tourniquet configured to be secured to a patient's bicep, said miniature projection head mounted to a portion of said tourniquet.
 2. A vein-imaging apparatus, for use in imaging the subcutaneous veins of a target area of a patient by a practitioner, said vein-imaging apparatus comprising: a miniature projection head, said miniature projection head comprising a first laser; a photodetector; a second laser, said first laser configured to transmit a beam of light at a selective wavelength, said photodetector configured to receive an image of the subcutaneous veins of the target area formed by differential absorption and reflection of said selective wavelength of light by the subcutaneous veins and the surrounding tissue, said photodetector further configured to provide an output representative of said received image, and said second laser configured to transmit a beam of laser light to selectively project said received image onto the target area using said output of said photodetector; and a housing configured to receive and support said first laser, said photodetector, and said second laser; said vein-imaging apparatus further comprising: a tourniquet configured for securement to a patient's bicep, said miniature projection head mounted to a portion of said tourniquet.
 3. The vein-imaging apparatus according to claim 2 wherein said miniature projection head further comprises a combiner configured to combine said first and second beams of laser light transmitted by said first and second lasers to be transmitted along a single optical path.
 4. The vein-imaging apparatus according to claim 3 wherein said miniature projection head further comprises a scanner, said scanner configured to scan said combined beams of laser light through an opening in said housing, and in a pattern onto the target area.
 5. The vein-imaging apparatus according to claim 4 wherein said beam of light from said first laser is transmitted at a first wavelength and said beam of light from said second laser is transmitted at a second wavelength, with said second wavelength of light being different from said first wavelength.
 6. The vein-imaging apparatus according to claim 5 wherein said first laser is configured to transmit light at one or more infrared wavelengths and said second laser is configured to transmit light at one or more visible wavelengths.
 7. The vein-imaging apparatus according to claim 6 wherein said first laser transmits light at a wavelength of 740 nm and said second laser transmits light at a wavelength of 630 nm. 